多层螺旋CT测量左心耳形态结构对房颤射频消融术患者左心耳血栓的诊断价值  

Diagnostic value of the measurement of left atrial appendage morphological structure by multi-slice spiral computed tomography on left atrial appendage thrombus in atrial fibrillation patients treated with radiofrequency ablation

作　　者：刘佳萍[1] 张卫国[2] LIU Jiaping;ZHANG Weiguo(Department of Medical Imaging,Beijing Chest Hospital,Capital Medical University,Beijing 101149,China;不详)

机构地区：[1]首都医科大学附属北京胸科医院医学影像科,北京市101149 [2]首都医科大学附属北京朝阳医院医学影像科

出　　处：《河北医药》2023年第15期2320-2323,共4页Hebei Medical Journal

基　　金：北京科技计划课题(编号:z151100002115049)。

摘　　要：目的分析多层螺旋CT测量左心耳形态结构对心房颤动(AF)射频消融术患者左心耳血栓的诊断价值。方法选定2020年8月至2022年8月接诊的100例拟行射频消融术治疗的AF患者,分别给予多层螺旋CT、经胸超声(TTE)检查,将实时三维经食管超声心动图(RT-3D-TEE)作为本次研究金标准,比较多层螺旋CT、TTE诊断左心耳血栓准确率、灵敏度、特异度,Kappa检验多层螺旋CT、TTE与RT-3D-TEE的一致性。另选取同期门诊体检中心体检的90例健康体检者做对比,比较左心耳血栓与健康人左心耳以及左心房参数CT测量值。结果多层螺旋CT诊断准确率(98.00%)、灵敏度(98.90%)、特异度(88.89%)均高于TTE(80.00%、86.81%、11.11%),Kappa检验多层螺旋CT与RT-3D-TEE一致性较好(Kappa值=0.573),TTE与RT-3D-TEE一致性一般(Kappa值=0.735)(P<0.05)。左心耳血栓者LAEF、LAEV均低于健康者,左心耳血栓者LAVmax、LAVmin、左心耳长径、短径均高于健康者(P<0.05)。左心耳血栓者LAAEV、LAAEF均低于健康者,左心耳血栓者LAAVmin、LAAVmax均高于健康者(P<0.05)。结论多层螺旋CT在拟行射频消融术AF患者左心耳血栓诊断中准确率、灵敏度以及特异度较高,同时可通过测量左心耳CT参数,对左心耳功能做出评价,具有一定的临床价值。Objective To analyze the diagnostic value of the measurement of left atrial appendage morphological structure by multi-slice spiral computed tomography(CT)on left atrial appendage thrombus in atrial fibrillation(AF)patients treated with radiofrequency ablation.Methods A total of 100 AF patients admitted to ouRhospital from August 2020 to August 2022 and treated with radiofrequency ablation were selected,and they were examined by multi-slice spiral CT and transthoracic ultrasonography(TTE).The results determined by the real-time three-dimensional transesophageal echocardiography(RT-3D TEE)was considered as the gold standard.The accuracy,sensitivity and specificity of multi-slice spiral CT and TTE in the diagnosis of left atrial appendage thrombus were compared with those of RT-3D TEE.The consistency of multi-slice CT,TTE and RT-3D TEE in diagnosing left atrial appendage thrombus in AF patients treated with radiofrequency ablation was detected by the Cohen’s kappa coefficient.During the same period,90 healthy subjects receiving physical examination in the outpatient physical examination centeRwere selected foRcomparing the CT measurement values of left atrial appendage and left atrial parameters with AF patients.Results The diagnostic accuracy(98.00%vs 80.00%),sensitivity(98.90%vs 86.81%)and specificity(88.89%vs 11.11%)of multi-slice spiral CT were all significantly higheRthan those of TTE.The consistency of multi-slice CT in diagnosing left atrial appendage with RT-3D TEE was good,with theκvalue of 0.573(P<0.05);while that of TTE was general(κ=0.735,P<0.05).The left atrial emptying fraction(LAEF)and left atrial emptying volume(LAEV)of AF patients with left atrial appendage thrombosis were significantly loweRthan those of healthy subjects,while the maximum left atrial volume(LAVmax),the minimum left atrial volume(LAVmin),and the long and short diameteRof the left atrial appendage were significantly higheR(P<0.05).The left atrial appendage emptying fraction(LAAEF)and left atrial appendage emptying volume(LAAEV)o

关 键 词：多层螺旋CT 左心耳形态结构 经胸超声 射频消融术 左心耳血栓 

分 类 号：R445.3[医药卫生—影像医学与核医学]